Nursing Ethics and Legal Liability Quiz

Legal Aspects in Nursing

•  Legal aspects in nursing are a compilation of lecture notes.
•  The lecture notes are compiled by Minda Boclog-Bahug.
•  The date of compilation is 12/16/2024.

Ethico-Moral

•  Ethical values, obligations, duties, and professional ideals of nurses individually and collectively.
•  It is a non-negotiable ethical standard.
•  It reflects nursing's commitment to society.

Values

•  Enduring beliefs or attitudes about the worth of a person, object, idea, or action.
•  Derived from cultural, ethnic, and religious background, societal traditions, peer groups, or family.
•  Examples include family, honesty, and hard work.

4 Values of Nursing

•  Strong commitment to service.
•  Belief in the dignity and worth of each person.
•  Commitment to education.
•  Autonomy.

Purposes of Value Clarification

• Increases self-awareness.
• Assists in decision making.
• Provides a better grasp of one's value system.
• Helpful in resolving ethical dilemmas.

Ethical Dilemma

•  A situation where a person must choose between two unfavorable alternatives.
•  Examples include assisted suicide and euthanasia.

Morals and Ethics

•  Morals are based on customs and habits; religious beliefs and social influence & group norms.
•  Morality refers to personal standards of what is right and wrong in conduct, character, and attitude.
•  Ethics are Greek in origin, meaning customs, habitual usage, conduct, and character.
•  It refers to fidelity and respect for the dignity, worth, and self-determination of patients.

Basic Ethical Concepts

•  Rights: Legal, social, and ethical principles of freedom or entitlement.
•  Autonomy: The right to make decisions (patients' right to refuse despite a nurse's explanation).
•  Beneficence and nonmaleficence: Beneficence is "do good" for the good and welfare of the client. Nonmaleficence is "do no harm" to the patient. A nurse has a duty to not cause harm to the patient.
•  Justice: Equality and fairness in terms of resources and personnel.
•  Veracity: Act of truthfulness.
•  Fidelity: Faithfulness and loyalty to clients.

Ethical Leadership

•  Involves principles of right, wrong, good, evil, virtue, duty, rights, obligations, justice, fairness in human relationships with each other.
•  It directs people and communities toward the common good; towards justice
•  Two essential leadership qualities: integrity and trustworthiness.

Components of Ethical Leadership

•  Gratitude, humility, justice, mercy and compassion, prudence and objectivity, magnanimity integrity and resilience.

Gratitude

•  Thankfulness and sincere expression of joy concerning gifts or kindness.
•  A virtue that shows humility when interacting with others; bringing humanity to leadership.

Humility

•  A virtue of modesty and unpretentiousness.
•  Employs strategies to make one known to their employees.
•  A humble leader also recognizes limitations, and mistakes, and attempts to correct them.

Justice

•  Governs behaviour; making people recognize the rights of others.
•  In the workplace, organizational justice is a predictor of work attitudes and behaviours.
•  It involves equality and fairness in terms of resources and personnel.

Mercy and Compassion

•  Shows understanding of the difficulties subordinates encounter during the execution of their duties.
•  Shows bravery facing the suffering of others instead of ignoring their pain; showing forgiveness.

Prudence and Objectivity

• Thoughtful deliberation before actions; examining ramifications to all parties involved to limit negative impacts.
•  Practicing prudence involves accuracy and precision; exact and deliberate actions are key.
•  Requires intelligence, patience, shrewdness, and circumstantial understanding.

Magnanimity

•  Leaders exhibit realistic vision, trust, forgiveness, the need to recognize accomplishments of subordinates.
•  Leaders are generous with their time; encouraging and inspiring subordinates

Integrity and Resilience

•  Integritas, is the Latin word defining personal values that direct a leader's behavior while adhering to moral values.
•  Regardless of religious background, integrity is respected, admired, and welcomed by employees.
•  Demonstrates expectation of fair play.
•  In contrast with integrity, corruption is associated with dysfunctional organizations that lack goals and employee commitment.

Principles of Ethical Leadership

- Includes qualities such as building community, manifesting honesty, respecting others, and showing justice. - Ethical leaders strive to have a process of influence and engage followers to accomplish mutual goals.

Treating Others as Ends (their own goals)

•  Deals with treating other people (employees) by considering their values, decisions, and individual differences as valuable and important.

Serving Others

•  Leaders have a duty to help others achieve their own legitimate interests.
•     Leaders serve as stewards of the organization's vision; clarifying, nurturing, and integrating with members.

Ethical Leaders and Followers

•  Ethical leaders should consider the purposes of all involved in the group and reach beyond individual goals.

Principles of Distributive Justice

•  These principles are applicable in various situations.
•  These principles include equitable share, individual need, individual rights, individual effort, societal contribution, and merit.

Manifests Honesty

•  Honest leaders are aware of others' feelings and attitudes.
•  They avoid being deceptive and promise only what they can deliver (honesty).
•  Honesty is consistent with openness, truthfulness, accountability, and acknowledging/rewarding honest behavior in the organization

Concern for Common Good

•  Leaders cannot impose their will on others but rather search to find goals that benefit everyone.
•  Leaders address the interests of the community and the culture.

Key Characteristics of Ethical Leadership

•  Moral conduct, ethical standards, moral purpose (moral vision), moral accomplishments, moral duty/responsibility, moral knowing, moral cooperation, and moral role modelling.

Nursing Code of Ethics

•  A formal statement of a group's values and ideals.
•  A set of ethical principles that members share.
•  Reflects moral judgments over time; serving as a benchmark for professional actions.

Purposes of Nursing Code of Ethics

•  Informing the public about minimum standards; helping understand professional nursing conduct
•  Signifying the profession's commitment to public service.
•  Outlining major ethical considerations of the profession.
•  Providing general guidelines for professional conduct.
•  Guiding self-regulation of professional behaviour.
•  Reminding nurses of their responsibilities when caring for clients.

Fundamental Responsibilities of Nurses

•  Promote health.
•  Prevent illness.
•  Restore health.
•  Alleviate suffering.

Elements of Nursing Code of Ethics

•  Nurses and people.
•  Nurses and practice.
•  Nurses and the profession.
•  Nurses and co-workers.

Code of Ethics for Filipino Nurses

- The hallmark of professionals is their willingness to accept and follow ethical principles.

•  This code outlines a commitment to principles higher than the law.
•  General principles include service to others, integrity, and professional competence; social responsibiltiy and global competitiveness
•  Adopted by the PRC in July 2003.

Article I (Preamble)

•  Health is a fundamental right of every individual.
•  Filipino registered nurses value the worth and dignity of each human being; primary responsibility to preserve health.
•  Includes promotion of health, prevention of illness, alleviation of suffering, and restoration of health.
•  If foregoing is not possible, assistance towards a peaceful death is also an obligation.

Article II (Registered Nurses and People)

•  Respecting values, customs, and beliefs.
•  Respecting individual freedom to make rational and unconstrained decisions
•  Maintaining confidentiality of personal information.
•  Prioritizing the needs of susceptible or vulnerable populations.
•  Promoting social justice.

Article III (Registered Nurses and Practice)

•  Maintaining ethical standards in practice/knowledge.
•  Committing to high-quality patient care through knowledge/scientific advancements.
•  Encouraging ethical behavior/transparency in nursing practice

Article IV (Registered Nurses and Co-workers)

•  Establishing/maintaining respectful relationships with co-workers.
•  Safeguarding individuals, families, and communities; intervening when a co-worker endangers someone's health.
•  Promoting ethical conduct amongst colleagues.

Article V (Registered Nurses, Society, and Environment)

•  Commitment to preserving life, respecting human rights, and promoting a healthy environment
•  Promoting links between nursing communities
•  Addressing local, national, and global health and social needs
•  Actively participate in and promote community health
•  Reflecting and promoting a professional attitude by setting precedence for the nursing profession.

Sec 14: Ethical Principles

• preserving life/respecting rights/promoting health environment are a nurse's obligations.
•  Linking with public in efforts to maintain local/national/international well-being

Guidelines to be Observed

• Being conscious of obligations as citizens; active role in community concerns
• Being equipped with knowledge of health resources; active role in primary healthcare
• Actively participating in programs that deal with societal problems
• Leading lives conforming to right conduct
• Projecting positive images for the nursing profession.

Article VI (Registered Nurses and the Profession)

- Maintaining loyalty; upholding the integrity of the profession. -  Adhering to the by-laws of nursing organizations (PNA).

•  Committing to ongoing development and growth of the profession in both learning/ active participation.

Article VII (Administrative Penalties, Repealing Clause, and Effectiveness)

•  The certificate of registration of a registered nurse may be revoked or suspended for violation of any provision in this code.
•  Codes of Ethics for nurses, technical standards for nursing practice, and policies of board/commission, or conditions/limitations of temporary permits.

Nurse Licensure Examination

•  A written exam with 500 items.
•     Filipino citizenship, reciprocity agreements, good moral character, and a BSN degree are crucial for qualification.

Ratings/Scope of Examination

•  A Grade Weight Average (GWA) 75% is required; no subject can obtain less than a 60%.
• Subjects below 60% must be repeated; a 75% rating is required to pass.
•  Scope of the exam is determined by the Board of Nursing (BON) according to nursing curriculum objectives

Oath

• All successful examinees are required to take an oath of their profession.
•   An administration official is to administer the oath prior to entering nursing practice.
•  The official (Oath-taking authority) may be a Board member or a government personnel.

Certificate of Registration

•  A required document issued to successful examinees upon payment of prescribed fees
•  Includes full name, serial number, and signatures of relevant personnel.
•  Issued with an official seal and professional identification cards.

Registration by Reciprocity

•  Issuance of COR without licensure examination for nurses from countries that have similar legal requirements.
•  The laws of this country will grant the same privileges as Filipino citizens to practitioners.

Practice Through Special/ Temporary Permit

• Foreign nurses may come to the Philippines on either a paid or not paid service basis.

• They may be well-known international specialists, or outstanding experts.

• Licensed nurses from a foreign country, employed by schools/colleges of nursing as exchange professors, may also be included for a special permit.

• Special/temporary permits must align with the project duration, medical mission, or employment contract.

Non-registration/ Non-Issuance of COR

• A person may be denied registration if convicted of moral turpitude, immoral, or dishonorable conduct; pronounced unsound of mind by court.
• This denial can be accompanied by a written notice explaining the reason.

Revocation/Suspension of COR

• The revocation/suspension occurs as a consequence for violations of the Act, rules, and regulations; unethical conduct (gross incompetence, serious ignorance); malpractice/negligence in practice; fraudulent use of statements; or violation of suspension from practice

• The period of suspension will not exceed 4 years.

Re-Issuance/ Replacement of COR

• A registered nurse may request a new COR certificate if their existing one is lost, mutilated or the cause for revocation has disappeared, been cured, or corrected.

Nursing Education

• Relevant information about requirements/qualifications for nurses in the Philippines.

Requirements for Inactive Nurses

•  Nurse who do not practice for 5 years.
• Requirements must be met to be able to practice once again.

Qualifications for Faculty Members

• Qualifications to be a faculty member in a Philippine Nursing program.
• The program must be accredited.

Duties and Responsibilities of a Nurse

• Provides nursing care using the nursing process, establishing linkages, and offering health education.

Qualifications of Nursing Administrators

• Basic requirements for a nursing administrator in the Philippines.
• Additional qualifications for a Chief Nurse/Director of Nursing Service include 5 years of supervisory experience and a master's degree major in Nursing.

Private or Civil Law: Definitions and Examples

• Tort law: A legal wrong committed against a person or their property. It can arise from denial, failure to comply with duties, or malpractices.
• Common examples of negligence include burns due to hot water bottles, falls from slippery surfaces, wrong medications/doses/patients, use of faulty equipment, or loss of belongings.

Legal Liabilities in Nursing

• Liability is a hindrance, resulting in disadvantages.
• It is the state of accountability for actions, or consequences.
• The four elements to establish proof of harm to a patient include the Nurses' duty of care, breach of that duty, causation, and any damages incurred.

Legal Issues in Nursing

• Legal issues are disputes that courts need to resolve. A significant portion of the legal issues in nursing relate to unintentional, intentional or quasi-intentional torts/breach of duty.
• Common issues include negligence (failure to follow appropriate safety procedures), malpractice (professional negligence), assault (threatening a patient), battery (unlawfully touching a patient), invasion of privacy (unnecessary exposure of patient), fraud (misrepresenting qualifications), and other legal rights/responsibilities.